Abstract
We experienced a case of alpha-fetoprotein (AFP)-produing gastric carcinoma of a 27-year-old man with accompanying acromegaly. His chief complaint was hematemesis. He was diagnosed with acromegaly at the age of 24, and underwent resection of the pituitary gland. Gastrofiberoscopy revealed a Borrmann type 2 gastric carcinoma just below the cardia, which seemed to be the source of bleeding. Endoscopic biopsy revealed poorly differentiated adenocarcinoma. Although abdominal computed tomography, ultrasonography and laboratory data did not sustain liver cirrhosis nor hepatitis, the serum AFP level was high, 53.1ng/ml (normal range≤20ng/ml). No distant metastasis was detected and proximal gastrectomy was performed. Borrmann type 2 gastric carcinoma measuring 3×2.5cm was located on the anterior wall of the cardia. The carcinoma showed invasion of the tunica muscularis, expansive growth and no vascular permeation. The resected specimen was examined immunohistochemically and no AFP was found in the carcinoma, but the level of serum AFP was normalized to 3.8ng/ml 21 days after surgery. Our final diagnosis was AFP-producing gastric carcinoma accompanied by acromegaly.
